Çağ Çal | Ege University (original) (raw)

Papers by Çağ Çal

Asian Pacific journal of cancer prevention: APJCP

There is a relative lack of epidemiological data on cancer in Turkey, which is a large country wi... more There is a relative lack of epidemiological data on cancer in Turkey, which is a large country with its 71 million population, since there was not any population-based registry functioning in the country before Izmir Cancer Registry (ICR), which was founded in 1992. The present study focused on the incidence of cancers of the genitourinary tract in Izmir province over a ten year period to cover the gap in this kind of epidemiological data for this part of the world. ICR is a population-based registry which collects data actively and is running international registration rules during procedures. We evaluated the data for 1993-2002. Annual crude and age-standardized incidence rates were calculated for the whole period and also for earlier and later periods. The age-standardized incidence rate (world population) for all sites was 198.3 per 100,000 for males and 116.4 per 100,000 for females. The most common primary sites for men were lung (35.6%), bladder (7.8%), colon and rectum (6.1%), larynx (5.7%) and prostate (5.4%). For women, the principal cancers were breast (28.7%), colon and rectum (7.2%), corpus uteri (5.3%), cervix uteri (4.8%) and lung (4.7%). Urogenital cancers accounted for 11.2% of all new cancer cases for the 1993-2002 period in Izmir. Of all urologic cancer cases, 89.6% were in males and 10.4% were in females. Carcinoma of the bladder was the first among the urogenital cancers in Izmir province (Age standardized incidence rate, world standard population ,17.1 per 100 000). Bladder cancer incidences were quite high, especially for men, and appear to be increasing. Prostate cancer has lower incidence rates as compared to western countries but the trend is for rise. There might be an underestimate of incidences, owing to an inability to use data from death certificates. Even so, the overall profile is an accurate reflection of incidence in this region of Turkey and provides much of the information required for planning strategies for cancer control.

Urology journal

To investigate the preferences and practice patterns of urooncologic surgeons in Turkey on bowel ... more To investigate the preferences and practice patterns of urooncologic surgeons in Turkey on bowel preparation and peri-operative management for radical cystectomy. This study was conducted by Turkish Urooncology Association as a multicenter survey. Participants were asked to fill in questionnaires dispensed at annual oncologic meeting or using internet access to the website of Urooncology Association. The questionnaire consisted of multiple choice or open-ended questions related to frequency of cystectomy, surgical technique and type of diversion, bowel preparation protocol, nasogastric tube applications, antibiotic prophylaxis, and deep vein thrombosis prophylaxis. Collected data from the survey were presented descriptively. Forty-four questionnaires from 44 surgeons of different centers were evaluated. All participants answered that they always perform bowel preparation before cystectomy. Four participants reported that they had an experience of cystectomy without bowel preparation...

Korean Journal of Urology, 2015

To investigate the efects of lymph node metastasis, skip metastasis, and other factors related to... more To investigate the efects of lymph node metastasis, skip metastasis, and other factors related to lymph node status on survival in patients who underwent radical cystectomy (RC) and extended lymph node dissection (eLND). Materials and Methods: RC and eLND were performed in 85 patients with a diagnosis of bladder cancer. Disease-free survival (DFS) and overall survival (OS) were determined by using a Cox proportional hazards model that included the number of excised lymph nodes, the presence of pathological lymph node metastasis, the anatomical level of positive nodes, the number of positive lymph nodes, lymph node density, and the presence of skip metastasis. Results: The mean number of lymph nodes removed per patient was 29.4±9.3. Lymph node positivity was detected in 85 patients (34.1%). The mean follow-up duration was 44.9±27.4 months (2-93 months). Five-year estimated OS and DFS for the 85 patients were 62.6% and 57%, respectively. Three of 29 lymph node-positive patients (10.3%) had skip metastasis. Only lymph node positivity had a signiicant efect on 5-year OS and DFS (p<0.001). No diference in OS and DFS was found between the three patients with skip metastasis and other lymph node-positive patients. Other factors related to lymph node status had no signiicant efect on 5-year OS and DFS. Conclusions: No factors related to lymph node status predict DFS and OS, except for lymph node positivity. OS and DFS were comparable between patients with skip metastasis and other lymph node-positive patients.

Asian Pacific journal of cancer prevention : APJCP

There is a relative lack of epidemiological data on cancer in Turkey, which is a large country wi... more There is a relative lack of epidemiological data on cancer in Turkey, which is a large country with its 71 million population, since there was not any population-based registry functioning in the country before Izmir Cancer Registry (ICR), which was founded in 1992. The present study focused on the incidence of cancers of the genitourinary tract in Izmir province over a ten year period to cover the gap in this kind of epidemiological data for this part of the world. ICR is a population-based registry which collects data actively and is running international registration rules during procedures. We evaluated the data for 1993-2002. Annual crude and age-standardized incidence rates were calculated for the whole period and also for earlier and later periods. The age-standardized incidence rate (world population) for all sites was 198.3 per 100,000 for males and 116.4 per 100,000 for females. The most common primary sites for men were lung (35.6%), bladder (7.8%), colon and rectum (6.1%...

Asian Pacific journal of cancer prevention : APJCP

Prostate cancer is one of the most common cancers in men, with a high incidence rates in Turkey. ... more Prostate cancer is one of the most common cancers in men, with a high incidence rates in Turkey. However, the early detection and diagnosis rates are considerably lower among Turkish men as compared with their counterparts in Western countries. This fact reflects a lack of awareness and fear of prostate cancer as well as low prevention activities. To reduce the disparities in prostate cancer survival, there is a great need to increase men's participation in screening programs. The present study was performed to assess why men do not seek screening or participate in screening programs, focusing on the demographics of men refusing a free screening program for prostate cancer.

European Urology Supplements, 2005

Sexual Dysfunction, 1998

ABSTRACT

Journal of Cancer Science & Therapy, 2011

European Urology Supplements, 2008

Urologia Internationalis, 2010

To investigate the efficacy of single or double epirubicin instillation during the early postoper... more To investigate the efficacy of single or double epirubicin instillation during the early postoperative period (EPP) in intermediate-risk non-muscle-invasive urothelial cancer. Patients with primary and solitary or multiple (3 or less) Ta (grade 2-3) or T1 (grade 1-2) tumors were enrolled. Patients were randomized to receive either a single dose of 100 mg epirubicin instillation within 6 h or a second 100 mg epirubicin instillation during the 12th-18th hours after a complete TUR-BT. At the end of the 60-month follow-up period, the available data were statistically analyzed. The end-points of the study were determined as disease-free survival, progression and recurrence rates, time to recurrence, and time to progression. A total of 299 patients from 24 institutions were randomized between January 2002 and June 2004. There were 143 patients from 18 institutions who met the eligibility criteria. The follow-up and disease-free survival periods were 16.9 months and 16 months, respectively. There was no statistical difference in the demographic properties and the end-points between the groups. A single dose of intravesical 100 mg epirubicin chemotherapy during the early postoperative period for primary intermediate-risk non-muscle-invasive urothelial cancer achieved 16 months of mean disease-free survival. A second intravesical epirubicin instillation did not provide any significant benefit.

Urologia Internationalis, 2012

We tried to establish the predictive factors influencing the initial response, as well as its dur... more We tried to establish the predictive factors influencing the initial response, as well as its duration, and time to castration resistance (CR) for primary advanced prostate cancer (PC) with bone metastasis. We evaluated all patients initially receiving androgen deprivation therapy (ADT) for primary advanced PC with bone metastasis. A total of 982 patients with complete medical records available for analysis from 18 centers were included in this study. Age, initial PSA, Gleason score (GS) and extent of bone involvement (EBI) were recorded in a database. Among all the patients, 896 (91.2%) responded to ADT initially. Pretreatment PSA and EBI were significant predictors in the multivariate model. Among the 659 patients who progressed into a CR state, the mean duration of response was 22.4 months. There was a significant correlation between the CR state and nadir PSA (nPSA) level and time to nPSA. Pretreatment PSA, EBI, GS, highest tumor volume in biopsy cores (%), number of positive biopsy cores, percent positive biopsy cores and time to nPSA were proven to be significant to predict a nPSA. Pretreatment PSA, GS and EBI were statistically significant predictors of PSA normalization in multivariate analysis. The limitation of the study depends on the retrospective design and a model was developed for low standardization as a result of using multicenter data. The patients enrolled in this study were from a relatively long period of time (1989-2008). The results of this study indicate that it is possible to predict the initial response to ADT by pretreatment PSA levels and EBI, while the duration of response can be reflected by a multitude of clinical factors including nPSA, TTnPSA, percent positive cores, biopsy GS and EBI.

Urological Oncology, 2008

Renal cell carcinoma (RCC) accounts for 3% of all adult cancers. The incidence rates for kidney c... more Renal cell carcinoma (RCC) accounts for 3% of all adult cancers. The incidence rates for kidney cancer are highest in European and Scandinavian countries and North America (1). It is estimated that 36,160 new cases of kidney and renal pelvis cancer were diagnosed in 2005, with an estimated 12,660 resulting deaths in the United States (2). There has been a

Urology, 2007

Renal hemorrhage is one of the most common and worrisome complications of percutaneous nephrolith... more Renal hemorrhage is one of the most common and worrisome complications of percutaneous nephrolithotomy (PCNL). This study attempted to identify variables that might influence hemorrhage during PCNL to help urologists establish preventative and treatment strategies for bleeding during PCNL procedures. The data of 193 patients (193 PCNL procedures) were retrospectively analyzed. Hemorrhage was estimated by the postoperative decrease in hematocrit factored by the quantity of any blood transfusion. Various preoperative and operative factors were assessed for their association with blood loss using univariate, forward multivariate regression and correlation analysis. The mean patient age was 45.7 +/- 14.4 years (range 5 to 74). The overall stone-free rate was 85.4%. The average hematocrit decrease was 8.7% +/- 5.39% (range 0.3 to 24.7). Forward multivariate regression analysis identified five significant variables that influenced PCNL-related hemorrhage: stone type (P = 0.003), number of tracts (P = 0.010), method of dilation (P = 0.010), diabetes (P = 0.022), and stone surface area (P = 0.049). A statistically significant difference was found in relation to the occurrence of hemorrhage between patients with caliceal stones and partial staghorn stones (P = 0.008) and complete staghorn stones (P = 0.006), single tracts and multiple tracts (P = 0.038), balloon dilators and Amplatz dilators (P = 0.007), patients with small stones (1000 mm2 or smaller) and large stones (greater than 1000 mm2; P = 0.018) on univariate analysis. Also, the stone surface area (P = 0.019) and number of tracts (P = 0.024) showed a positive correlation with the mean hematocrit decrease. Staghorn stones, multiple tracts, the presence of diabetes, and large stones were associated with increased renal hemorrhage during PCNL on multivariate analysis. However, balloon dilation was associated with decreased hemorrhage.

Urology, 2007

To evaluate the accuracy of frozen section examination (FSE) for detecting lymph node (LN) metast... more To evaluate the accuracy of frozen section examination (FSE) for detecting lymph node (LN) metastasis in patients with bladder cancer undergoing radical cystectomy and pelvic LN dissection. To our knowledge, the accuracy of FSE to identify LN metastases in patients with bladder cancer is still undetermined. The clinical data of 360 patients who had undergone radical cystectomy with pelvic lymphadenectomy for bladder cancer in six urologic institutions were retrospectively analyzed. The nodal regions included were the external iliac, hypogastric, and obturator LNs. The FSE results of the right and left LN regions were compared with the final histopathologic results of the respective LN regions. The final pathologic examination revealed nodal metastases in 65 patients (18.1%). Of the 720 right and left LN regions in 360 patients, 88 (12.2%) were metastatic at the final pathologic examination. Although the FSE findings were negative, the final pathologic examination revealed LN metastases in 26 patients and in 29 pelvic LN regions. All LN regions with positive FSE findings were positive at the final pathologic examination. When we considered the 720 LN regions, the sensitivity, specificity, and positive and negative predictive values for FSE were 67%, 100%, 100%, and 95.6%, respectively. Until innovations in imaging methods improve nodal staging in patients with bladder cancer, performing FSE of the external iliac, hypogastric, and obturator LNs seems to be a reliable procedure for the evaluation of the LNs. The information obtained with FSE of the LNs can be used to determine intraoperatively the extent of LN dissection.

Urology, 2009

To examine, in a multicenter validation study designed under the guidance of the Uro-Oncology Soc... more To examine, in a multicenter validation study designed under the guidance of the Uro-Oncology Society, the predictive accuracies of the 1998 and 2006 Kattan preoperative nomograms in Turkish patients. These 2 preoperative Kattan nomograms use preoperative parameters to estimate disease recurrence after radical prostatectomy.

Urologic Oncology: Seminars and Original Investigations, 2013

Background: Testicular self-examination is the easiest and cheapest way to scan testicular cancer... more Background: Testicular self-examination is the easiest and cheapest way to scan testicular cancer. However, the public awareness about testicular self-examination is very low. We aimed to investigate the public awareness of Turkish people about testicular cancer and testicular self-examination.

The Journal of Urology, 2009

regression analysis. RESULTS: Forty-five patients were diagnosed with LS. The average age was 50.... more regression analysis. RESULTS: Forty-five patients were diagnosed with LS. The average age was 50.2 years (range 22.5-82.9) with an average follow-up of 44.2 months. Circumcision or meatotomy was performed in 10, and 7 were treated with clobetasol alone. Twenty-five had urethral disease necessitatinf 26 open surgical repairs. Meatoplasty was performed in 12 (46%), staged repair in 9 (35%), perineal urethrostomy in 4 (15%), and augmented repair in 1 (4%). Recurrent LS was diagnosed in 8 (32%) patients and confirmed with biopsy. Of the recurrences, 1 had undergone extended meatoplasty and 7 recurred following staged procedures: 4 after the first stage, and 3 after completion of the two-staged repair. One patient who had recurrence after a two-stage procedure, also had recurrent LS at the site of subsequent perineal urethrostomy. Younger age at time of diagnosis (p=0.044), bulbar urethra as site of LS (p=0.018), staged urethroplasty as type of intervention (p=0.003), increased number of prior endoscopic procedures (p=0.035), and increased number of prior open procedures (p=0.049) were associated with increased risk of LS recurrence. Race, circumcision status, treatment with steroid cream, and medical co-morbidities were not found to be significant. Multivariate logistic regression analysis did not find any independent risk factors for recurrent LS, though number of prior endoscopic procedures trended towards significance (p=0.12).

Journal of Clinical Ultrasound, 2000

Primary carcinoma arising in the urothelium of the ureter is rare, accounting for only 1% of all ... more Primary carcinoma arising in the urothelium of the ureter is rare, accounting for only 1% of all cancers of the upper urinary tract. We describe a case in which primary transitional cell carcinoma of the right ureter was sonographically detected in a 45year-old woman. The mass exhibited tumoral vascularity on power Doppler sonography and spectral analysis.

International Urology and Nephrology, 1998

Schwannoma which originated from Schwann cells is a nerve sheath tumour. Schwannomas of the uroge... more Schwannoma which originated from Schwann cells is a nerve sheath tumour. Schwannomas of the urogenital tract are very rare. We present a case of a juxtadrenal schwannoma in a 66 years old female patient. To date only three juxtadrenal schwannoma cases have been described in the literature.

International Urology and Nephrology, 2011

Objectives Upper urinary tract urothelial carcinomas are relatively rare malignancies. The aim of... more Objectives Upper urinary tract urothelial carcinomas are relatively rare malignancies. The aim of this study was to investigate the factors affecting prognosis of patients undergoing nephroureterectomy. Methods Data of 140 patients undergoing nephroureterectomy were retrospectively analyzed. Age of patients, gender, focality and localization of tumor, clinical and pathological stage, relationship with bladder cancer (prior, synchronous, after), and history of smoking were retrospectively recorded. The condition of local recurrence, metastases to distant organs, and requirement of adjuvant treatment were evaluated. Results The disease-specific and recurrence-free 5-year survival rate was determined as 78.9 and 68.4%, respectively. Bladder recurrence was determined in 20 of the patients after a mean of 21 months (7-37 months). Relationship between the duration of recurrence and variables showed that patients with T2 and higher stages (P = 0.014), with high-grade tumors (P = 0.028), with multifocal tumors (P \ 0.001), and patients who were cigarette smokers (P = 0.010) had significantly shorter durations of recurrence. The mean survival of the 19 (18.1%) patients who had distant metastases was 19 months. Pathological stage T2 and higher tumors (P = 0.006), nodal involvement (P = 0.04), high-grade urothelial carcinoma (P \ 0.001), multifocal tumors (P \ 0.001), and tumors localized in the ureter (P \ 0.001) were observed to have shorter duration of metastatic development. Conclusions Presence of T2 and higher-stage tumors, high-grade tumors, and multifocality are combined risk factors for urinary bladder recurrence and distant organ metastasis. Patients with the additional risk factors of cigarette smoking (urinary bladder recurrence) and nodal disease (distant organ metastasis) should be followed up closely after surgery.

Asian Pacific journal of cancer prevention: APJCP

There is a relative lack of epidemiological data on cancer in Turkey, which is a large country wi... more There is a relative lack of epidemiological data on cancer in Turkey, which is a large country with its 71 million population, since there was not any population-based registry functioning in the country before Izmir Cancer Registry (ICR), which was founded in 1992. The present study focused on the incidence of cancers of the genitourinary tract in Izmir province over a ten year period to cover the gap in this kind of epidemiological data for this part of the world. ICR is a population-based registry which collects data actively and is running international registration rules during procedures. We evaluated the data for 1993-2002. Annual crude and age-standardized incidence rates were calculated for the whole period and also for earlier and later periods. The age-standardized incidence rate (world population) for all sites was 198.3 per 100,000 for males and 116.4 per 100,000 for females. The most common primary sites for men were lung (35.6%), bladder (7.8%), colon and rectum (6.1%), larynx (5.7%) and prostate (5.4%). For women, the principal cancers were breast (28.7%), colon and rectum (7.2%), corpus uteri (5.3%), cervix uteri (4.8%) and lung (4.7%). Urogenital cancers accounted for 11.2% of all new cancer cases for the 1993-2002 period in Izmir. Of all urologic cancer cases, 89.6% were in males and 10.4% were in females. Carcinoma of the bladder was the first among the urogenital cancers in Izmir province (Age standardized incidence rate, world standard population ,17.1 per 100 000). Bladder cancer incidences were quite high, especially for men, and appear to be increasing. Prostate cancer has lower incidence rates as compared to western countries but the trend is for rise. There might be an underestimate of incidences, owing to an inability to use data from death certificates. Even so, the overall profile is an accurate reflection of incidence in this region of Turkey and provides much of the information required for planning strategies for cancer control.

Urology journal

To investigate the preferences and practice patterns of urooncologic surgeons in Turkey on bowel ... more To investigate the preferences and practice patterns of urooncologic surgeons in Turkey on bowel preparation and peri-operative management for radical cystectomy. This study was conducted by Turkish Urooncology Association as a multicenter survey. Participants were asked to fill in questionnaires dispensed at annual oncologic meeting or using internet access to the website of Urooncology Association. The questionnaire consisted of multiple choice or open-ended questions related to frequency of cystectomy, surgical technique and type of diversion, bowel preparation protocol, nasogastric tube applications, antibiotic prophylaxis, and deep vein thrombosis prophylaxis. Collected data from the survey were presented descriptively. Forty-four questionnaires from 44 surgeons of different centers were evaluated. All participants answered that they always perform bowel preparation before cystectomy. Four participants reported that they had an experience of cystectomy without bowel preparation...

Korean Journal of Urology, 2015

To investigate the efects of lymph node metastasis, skip metastasis, and other factors related to... more To investigate the efects of lymph node metastasis, skip metastasis, and other factors related to lymph node status on survival in patients who underwent radical cystectomy (RC) and extended lymph node dissection (eLND). Materials and Methods: RC and eLND were performed in 85 patients with a diagnosis of bladder cancer. Disease-free survival (DFS) and overall survival (OS) were determined by using a Cox proportional hazards model that included the number of excised lymph nodes, the presence of pathological lymph node metastasis, the anatomical level of positive nodes, the number of positive lymph nodes, lymph node density, and the presence of skip metastasis. Results: The mean number of lymph nodes removed per patient was 29.4±9.3. Lymph node positivity was detected in 85 patients (34.1%). The mean follow-up duration was 44.9±27.4 months (2-93 months). Five-year estimated OS and DFS for the 85 patients were 62.6% and 57%, respectively. Three of 29 lymph node-positive patients (10.3%) had skip metastasis. Only lymph node positivity had a signiicant efect on 5-year OS and DFS (p<0.001). No diference in OS and DFS was found between the three patients with skip metastasis and other lymph node-positive patients. Other factors related to lymph node status had no signiicant efect on 5-year OS and DFS. Conclusions: No factors related to lymph node status predict DFS and OS, except for lymph node positivity. OS and DFS were comparable between patients with skip metastasis and other lymph node-positive patients.

Asian Pacific journal of cancer prevention : APJCP

There is a relative lack of epidemiological data on cancer in Turkey, which is a large country wi... more There is a relative lack of epidemiological data on cancer in Turkey, which is a large country with its 71 million population, since there was not any population-based registry functioning in the country before Izmir Cancer Registry (ICR), which was founded in 1992. The present study focused on the incidence of cancers of the genitourinary tract in Izmir province over a ten year period to cover the gap in this kind of epidemiological data for this part of the world. ICR is a population-based registry which collects data actively and is running international registration rules during procedures. We evaluated the data for 1993-2002. Annual crude and age-standardized incidence rates were calculated for the whole period and also for earlier and later periods. The age-standardized incidence rate (world population) for all sites was 198.3 per 100,000 for males and 116.4 per 100,000 for females. The most common primary sites for men were lung (35.6%), bladder (7.8%), colon and rectum (6.1%...

Asian Pacific journal of cancer prevention : APJCP

Prostate cancer is one of the most common cancers in men, with a high incidence rates in Turkey. ... more Prostate cancer is one of the most common cancers in men, with a high incidence rates in Turkey. However, the early detection and diagnosis rates are considerably lower among Turkish men as compared with their counterparts in Western countries. This fact reflects a lack of awareness and fear of prostate cancer as well as low prevention activities. To reduce the disparities in prostate cancer survival, there is a great need to increase men's participation in screening programs. The present study was performed to assess why men do not seek screening or participate in screening programs, focusing on the demographics of men refusing a free screening program for prostate cancer.

European Urology Supplements, 2005

Sexual Dysfunction, 1998

ABSTRACT

Journal of Cancer Science & Therapy, 2011

European Urology Supplements, 2008

Urologia Internationalis, 2010

To investigate the efficacy of single or double epirubicin instillation during the early postoper... more To investigate the efficacy of single or double epirubicin instillation during the early postoperative period (EPP) in intermediate-risk non-muscle-invasive urothelial cancer. Patients with primary and solitary or multiple (3 or less) Ta (grade 2-3) or T1 (grade 1-2) tumors were enrolled. Patients were randomized to receive either a single dose of 100 mg epirubicin instillation within 6 h or a second 100 mg epirubicin instillation during the 12th-18th hours after a complete TUR-BT. At the end of the 60-month follow-up period, the available data were statistically analyzed. The end-points of the study were determined as disease-free survival, progression and recurrence rates, time to recurrence, and time to progression. A total of 299 patients from 24 institutions were randomized between January 2002 and June 2004. There were 143 patients from 18 institutions who met the eligibility criteria. The follow-up and disease-free survival periods were 16.9 months and 16 months, respectively. There was no statistical difference in the demographic properties and the end-points between the groups. A single dose of intravesical 100 mg epirubicin chemotherapy during the early postoperative period for primary intermediate-risk non-muscle-invasive urothelial cancer achieved 16 months of mean disease-free survival. A second intravesical epirubicin instillation did not provide any significant benefit.

Urologia Internationalis, 2012

We tried to establish the predictive factors influencing the initial response, as well as its dur... more We tried to establish the predictive factors influencing the initial response, as well as its duration, and time to castration resistance (CR) for primary advanced prostate cancer (PC) with bone metastasis. We evaluated all patients initially receiving androgen deprivation therapy (ADT) for primary advanced PC with bone metastasis. A total of 982 patients with complete medical records available for analysis from 18 centers were included in this study. Age, initial PSA, Gleason score (GS) and extent of bone involvement (EBI) were recorded in a database. Among all the patients, 896 (91.2%) responded to ADT initially. Pretreatment PSA and EBI were significant predictors in the multivariate model. Among the 659 patients who progressed into a CR state, the mean duration of response was 22.4 months. There was a significant correlation between the CR state and nadir PSA (nPSA) level and time to nPSA. Pretreatment PSA, EBI, GS, highest tumor volume in biopsy cores (%), number of positive biopsy cores, percent positive biopsy cores and time to nPSA were proven to be significant to predict a nPSA. Pretreatment PSA, GS and EBI were statistically significant predictors of PSA normalization in multivariate analysis. The limitation of the study depends on the retrospective design and a model was developed for low standardization as a result of using multicenter data. The patients enrolled in this study were from a relatively long period of time (1989-2008). The results of this study indicate that it is possible to predict the initial response to ADT by pretreatment PSA levels and EBI, while the duration of response can be reflected by a multitude of clinical factors including nPSA, TTnPSA, percent positive cores, biopsy GS and EBI.

Urological Oncology, 2008

Renal cell carcinoma (RCC) accounts for 3% of all adult cancers. The incidence rates for kidney c... more Renal cell carcinoma (RCC) accounts for 3% of all adult cancers. The incidence rates for kidney cancer are highest in European and Scandinavian countries and North America (1). It is estimated that 36,160 new cases of kidney and renal pelvis cancer were diagnosed in 2005, with an estimated 12,660 resulting deaths in the United States (2). There has been a

Urology, 2007

Renal hemorrhage is one of the most common and worrisome complications of percutaneous nephrolith... more Renal hemorrhage is one of the most common and worrisome complications of percutaneous nephrolithotomy (PCNL). This study attempted to identify variables that might influence hemorrhage during PCNL to help urologists establish preventative and treatment strategies for bleeding during PCNL procedures. The data of 193 patients (193 PCNL procedures) were retrospectively analyzed. Hemorrhage was estimated by the postoperative decrease in hematocrit factored by the quantity of any blood transfusion. Various preoperative and operative factors were assessed for their association with blood loss using univariate, forward multivariate regression and correlation analysis. The mean patient age was 45.7 +/- 14.4 years (range 5 to 74). The overall stone-free rate was 85.4%. The average hematocrit decrease was 8.7% +/- 5.39% (range 0.3 to 24.7). Forward multivariate regression analysis identified five significant variables that influenced PCNL-related hemorrhage: stone type (P = 0.003), number of tracts (P = 0.010), method of dilation (P = 0.010), diabetes (P = 0.022), and stone surface area (P = 0.049). A statistically significant difference was found in relation to the occurrence of hemorrhage between patients with caliceal stones and partial staghorn stones (P = 0.008) and complete staghorn stones (P = 0.006), single tracts and multiple tracts (P = 0.038), balloon dilators and Amplatz dilators (P = 0.007), patients with small stones (1000 mm2 or smaller) and large stones (greater than 1000 mm2; P = 0.018) on univariate analysis. Also, the stone surface area (P = 0.019) and number of tracts (P = 0.024) showed a positive correlation with the mean hematocrit decrease. Staghorn stones, multiple tracts, the presence of diabetes, and large stones were associated with increased renal hemorrhage during PCNL on multivariate analysis. However, balloon dilation was associated with decreased hemorrhage.

Urology, 2007

To evaluate the accuracy of frozen section examination (FSE) for detecting lymph node (LN) metast... more To evaluate the accuracy of frozen section examination (FSE) for detecting lymph node (LN) metastasis in patients with bladder cancer undergoing radical cystectomy and pelvic LN dissection. To our knowledge, the accuracy of FSE to identify LN metastases in patients with bladder cancer is still undetermined. The clinical data of 360 patients who had undergone radical cystectomy with pelvic lymphadenectomy for bladder cancer in six urologic institutions were retrospectively analyzed. The nodal regions included were the external iliac, hypogastric, and obturator LNs. The FSE results of the right and left LN regions were compared with the final histopathologic results of the respective LN regions. The final pathologic examination revealed nodal metastases in 65 patients (18.1%). Of the 720 right and left LN regions in 360 patients, 88 (12.2%) were metastatic at the final pathologic examination. Although the FSE findings were negative, the final pathologic examination revealed LN metastases in 26 patients and in 29 pelvic LN regions. All LN regions with positive FSE findings were positive at the final pathologic examination. When we considered the 720 LN regions, the sensitivity, specificity, and positive and negative predictive values for FSE were 67%, 100%, 100%, and 95.6%, respectively. Until innovations in imaging methods improve nodal staging in patients with bladder cancer, performing FSE of the external iliac, hypogastric, and obturator LNs seems to be a reliable procedure for the evaluation of the LNs. The information obtained with FSE of the LNs can be used to determine intraoperatively the extent of LN dissection.

Urology, 2009

To examine, in a multicenter validation study designed under the guidance of the Uro-Oncology Soc... more To examine, in a multicenter validation study designed under the guidance of the Uro-Oncology Society, the predictive accuracies of the 1998 and 2006 Kattan preoperative nomograms in Turkish patients. These 2 preoperative Kattan nomograms use preoperative parameters to estimate disease recurrence after radical prostatectomy.

Urologic Oncology: Seminars and Original Investigations, 2013

Background: Testicular self-examination is the easiest and cheapest way to scan testicular cancer... more Background: Testicular self-examination is the easiest and cheapest way to scan testicular cancer. However, the public awareness about testicular self-examination is very low. We aimed to investigate the public awareness of Turkish people about testicular cancer and testicular self-examination.

The Journal of Urology, 2009

regression analysis. RESULTS: Forty-five patients were diagnosed with LS. The average age was 50.... more regression analysis. RESULTS: Forty-five patients were diagnosed with LS. The average age was 50.2 years (range 22.5-82.9) with an average follow-up of 44.2 months. Circumcision or meatotomy was performed in 10, and 7 were treated with clobetasol alone. Twenty-five had urethral disease necessitatinf 26 open surgical repairs. Meatoplasty was performed in 12 (46%), staged repair in 9 (35%), perineal urethrostomy in 4 (15%), and augmented repair in 1 (4%). Recurrent LS was diagnosed in 8 (32%) patients and confirmed with biopsy. Of the recurrences, 1 had undergone extended meatoplasty and 7 recurred following staged procedures: 4 after the first stage, and 3 after completion of the two-staged repair. One patient who had recurrence after a two-stage procedure, also had recurrent LS at the site of subsequent perineal urethrostomy. Younger age at time of diagnosis (p=0.044), bulbar urethra as site of LS (p=0.018), staged urethroplasty as type of intervention (p=0.003), increased number of prior endoscopic procedures (p=0.035), and increased number of prior open procedures (p=0.049) were associated with increased risk of LS recurrence. Race, circumcision status, treatment with steroid cream, and medical co-morbidities were not found to be significant. Multivariate logistic regression analysis did not find any independent risk factors for recurrent LS, though number of prior endoscopic procedures trended towards significance (p=0.12).

Journal of Clinical Ultrasound, 2000

Primary carcinoma arising in the urothelium of the ureter is rare, accounting for only 1% of all ... more Primary carcinoma arising in the urothelium of the ureter is rare, accounting for only 1% of all cancers of the upper urinary tract. We describe a case in which primary transitional cell carcinoma of the right ureter was sonographically detected in a 45year-old woman. The mass exhibited tumoral vascularity on power Doppler sonography and spectral analysis.

International Urology and Nephrology, 1998

Schwannoma which originated from Schwann cells is a nerve sheath tumour. Schwannomas of the uroge... more Schwannoma which originated from Schwann cells is a nerve sheath tumour. Schwannomas of the urogenital tract are very rare. We present a case of a juxtadrenal schwannoma in a 66 years old female patient. To date only three juxtadrenal schwannoma cases have been described in the literature.

International Urology and Nephrology, 2011

Objectives Upper urinary tract urothelial carcinomas are relatively rare malignancies. The aim of... more Objectives Upper urinary tract urothelial carcinomas are relatively rare malignancies. The aim of this study was to investigate the factors affecting prognosis of patients undergoing nephroureterectomy. Methods Data of 140 patients undergoing nephroureterectomy were retrospectively analyzed. Age of patients, gender, focality and localization of tumor, clinical and pathological stage, relationship with bladder cancer (prior, synchronous, after), and history of smoking were retrospectively recorded. The condition of local recurrence, metastases to distant organs, and requirement of adjuvant treatment were evaluated. Results The disease-specific and recurrence-free 5-year survival rate was determined as 78.9 and 68.4%, respectively. Bladder recurrence was determined in 20 of the patients after a mean of 21 months (7-37 months). Relationship between the duration of recurrence and variables showed that patients with T2 and higher stages (P = 0.014), with high-grade tumors (P = 0.028), with multifocal tumors (P \ 0.001), and patients who were cigarette smokers (P = 0.010) had significantly shorter durations of recurrence. The mean survival of the 19 (18.1%) patients who had distant metastases was 19 months. Pathological stage T2 and higher tumors (P = 0.006), nodal involvement (P = 0.04), high-grade urothelial carcinoma (P \ 0.001), multifocal tumors (P \ 0.001), and tumors localized in the ureter (P \ 0.001) were observed to have shorter duration of metastatic development. Conclusions Presence of T2 and higher-stage tumors, high-grade tumors, and multifocality are combined risk factors for urinary bladder recurrence and distant organ metastasis. Patients with the additional risk factors of cigarette smoking (urinary bladder recurrence) and nodal disease (distant organ metastasis) should be followed up closely after surgery.